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Review of 'Focusing ADHD' event by Dr Muzaffer Kaser

The Cambridge Science Festival 2013 hosted the public event ‘Focusing ADHD’ (Attention Deficit Hyperactivity Disorder) on 14th March 2013. Panel members included Professor Trevor Robbins, Dr Sam Chamberlain and Dr Ulrich Muller.

‘Focusing ADHD’ took place at the Babbage Lecture Theatre and attracted approximately 400 people. Keypads were provided to the audience for a set of interactive questions during the event. Just over a third of the audience had been diagnosed with ADHD or had a relative or friend who had been diagnosed with ADHD.

In his introduction, Professor Trevor Robbins emphasized the different levels of understanding ADHD. He defined these levels as follows: the psychiatric level including the diagnosis and phenomenological aspects of the ADHD, the psychological level incorporating behavioural traits, the brain level in relation to changes in neurons and neural connections, and finally the genetic level regarding heritability and genetic variations making people vulnerable to ADHD. Professor Robbins explained that brain research spanning these levels is crucial for understanding the mechanisms underlying ADHD and its effective treatment.

In his talk on the historical background to ADHD, Dr Muller discussed clinical observations suggesting the existence of ADHD date from as early as the 18th century. He also mentioned that the drugs available for ADHD are among the oldest drugs in psychiatry and their safety profiles are well known. Dr Muller reviewed cross-cultural epidemiological research showing that the prevalence of ADHD in children and adults are quite similar across countries all over the world. He emphasized that consequences of untreated ADHD can be severe, including a higher rate of co-morbid psychiatric conditions, increased risk for drug abuse and criminality. As an expert on psychopharmacology, he explained the mechanisms of medication on brain structure and showed how these effects can be observed as changes in brain functioning measured by functional and pharmacological neuroimaging.

Dr Sam Chamberlain covered research on the cognitive impairments of ADHD and how these relate to everyday functioning. Regarding the big controversies covering ADHD treatment, he made practical and clear comments on the benefits and side effects of currently available treatments for ADHD. Firstly, he referred to the NICE Guidelines, which suggest psychosocial interventions, namely cognitive behavioural therapy and group based interventions for mild to moderate cases of ADHD in children. He also emphasised the importance of  ‘choice of treatment’ for adult patients. He clearly showed that the level of evidence for the efficacy of methylphenidate treatment is robust and meta-analysis of randomised controlled trials also exhibited a clear benefit of this group of drugs. Dr Chamberlain also illustrated recent findings on the comparing the effect sizes of drug treatments in psychiatric and other medical conditions. Perhaps surprisingly, stimulant drug medication had an effect size comparable to that of many other medical treatments for distinct diseases or disorders. 

The last panel speaker was Mr Terry Laverty who was himself diagnosed with ADHD at the age of 33. Mr Laverty related his personal story and how he had used his experience in the support group ADDapt Ability. Terry shared moving stories from childhood, including bullying through his primary school and teenage years. He had suffered from depressive mood and at the time neither he nor his psychiatric team realised the link between his emotional problems and ADHD symptoms. During his degree, Terry found himself enjoying surfing and eventually became a surf instructor. Through ADDapt Ability Terry campaigns about under-diagnosis of ADHD. He said:“You can only be helped if you are bad enough, otherwise your problems are overlooked until you reach a stage of crisis”.

The event ended with a stimulating discussion between panel members and the audience, with the audience having had the opportunity to tweet in questions before the event.

Adapted from a piece written for the British Association for Psychopharmacology by Dr Muzaffer Kaser, Psychiatrist and PhD Candidate at Department of Psychiatry

Posted on 12/04/2013

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